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General NPI Number Information
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NPI Number | 1013265024
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Entity Type | Organization
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Legal Business Name | PATRICIA MASKOW FIREM, PH.D., LLC
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Dates
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Enumeration Date | 08/22/2012
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Last Update Date | 08/22/2012
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Provider Practice Location Address
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Address Line | 401 SOUTH ST 2B
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City | CHARDON
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State | OH
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Zip | 44024-2805
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Country | US
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Telephone | 440-285-8746
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Fax | 440-285-8746
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Provider Business Mailing Address
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Address Line | 401 SOUTH ST 2B
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City | CHARDON
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State | OH
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Zip | 44024-2805
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Country | US
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Telephone | 440-285-8746
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Fax | 440-285-8746
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA MASKOW FIREM
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Credential | PH.D.
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Telephone | 440-285-8746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5127
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License Number State | OH
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